finally got a half day!

---

25 April Tues


green ortho team...the one i'm attached to...was on trauma call today...

followed morning round...the professor....bobby john...was very kind....he's also head of ortho...taught a lot during the round.....would put up the xray...then ask me to comment and then ask his residents questions on management....

they have quite a few patients spread in many wards...trying to remember which patient had what diagnosis...

then took some time off to do some reading....the department has its small libray...but the books are too difficult....

after lunch went to the student lib....a book called Essential orthopaedics is quite good.....

in the afternoon..there's paedi ortho clinic...saw a few cases....club foot...gets sleepy when you don't know what the conversation is all about.

then went to the casualty...two cases came in.....if wasn't at the clinic, then would be able to see them when admitted....

1. middle age male was cutting a tree...but somehow the tree fell on him when he was running away.....ended up with # medial malleolus on one foot and # metatarsal on the other....also had spinal and rib #.....

2. middle age male was riding a skooter....hit by a jeep head on....the bumper must have hit his leg....his tibia and fibula were both crushed with an open #...and the knee joint was involved as well......

hanged around for a bit while they managed the two and sorted out the papers.....turns out that as this is a private hospital, the patients have to pay before they get operated on.....if come into the casualty and require surgery..then need to pay 10,000Rs down payment.

went to dinner meanwhile...
kandi came back with me to look at the OT....

the first one didn't get started till 8pm...and we saw a bit of that....but we both wanted to look the second one...
which didn't start till 1030...
it was one of the most gruesome things i've ever seen....there was a big cut over the leg and you could see the tibia with its sharp edges....what i thought at the casualty was packing turned out to be dead muscle which has become dull red....
and as both bones were fractured....the only thing holding the leg together was the muscles and skin....so it was extraflexible....

so first they did the debridement and take away the loose fragments...
and the surgeon asked us to scrub up! there was hardly anyone in the OT helping him
didn't know a relaxed leg weighed sooo much.....i guess really need to go to the gym if i wanna do ortho

after a while and when they've draped everything....it just looked a bit like a piece of meat....with the bones being chopped up at the butchers....
they reduced the fracture and put in screws to fixate it externally and left the wound open.....
we left at 1215...when they were about done......

definitely won't get the chance to see something like his in HK....
hm....RTA are really nasty...


26 April WED

after the late night.....a bit difficult to get up....
turned out the OT went on till 2...and the residents only got 3-4 hours sleep....
OPD whole day.....it's so boring.....struggled to stay awake....though managed to see a few interesting cases....it was a long long day...

so happy to hear when they finish at 330....skipped a lesson at 4....the residents sat around to talk about pathological #. instead went out with the girls to Ansal plaza instead....

rediscovering the way to ride rickshaw....choose the ones where there're already people...so it becomes like a red minibus...instead of hiring the whole taxi....then they charge a fixed rate from 3-8Rs....and won't quote you ridiculous prices of 60Rs for a short trip....
and it actually feels safer to have other local passengers onboard as well...

but then sometimes you have to change...they'll take you to the local atta...which is the local bus station....basically where the rickshaws gather...there you get onto another to your destination...like changing buses...

went to KFC this time....ate so much chicken....good...but similar to KFC elsewhere....and the drinks are a bit small...
chicken here tastes very good....the meat is very juicy and tender...but maybe the KFC stuff is imported....cos it's not as good as the local chicken...

met some students there and they told us where the supermarket is....so went there after dinner.....it's like walmart but smaller.....

girls were looking at the clothes...and joyjoy got some shoes....
the saree they bought at chandigrah finally arrived....
we bought the cloth at mrs. gandhi shop and they said they would get it stitched and sent it up....
but i was starting to think if they didn't arrive soon...then there wouln't have time to wear it...
as we looked around...we realized their saree was v v expensive....
though it was pretty...
hm...should be more careful next time...too trusting

also bought some water and biscuits....
no time to get the jeans....maybe will have to get some later

after get back...sorted out some of the HO stuff.....ranked the hospitals by their popularity according to last year's selections for each specialty.turned out QE was most popular for almost all specialties....now thinking how to put in my choices.....maybe put a few ortho at the top...then groups of 3. or maybe all groups of 4.....



27 April Thurs
OT day again today...the ortho team runs in cycle of three....one elective OT, then trauma call...then OPD...
only got 3 today....

there was a child...saw him on tues in the OPD....he had a swelling in the left 4th middle phalanges...and also a very big cold abscess at the axilla...so big that he couldn't put his arm straight down

the finger swelling turned out to be TB osteomyelitis...the bone has bulged out and is hollow inside...

so they operated on him today.....also scrubbed up...but nothing for me to do....
debride the finger.....and then poured some streptomycin powder in.

and aspirated the abscess.....30ml of pus came out....and the ball collapsed. then they put the streptomycin in solution and injected it back in.....


finally got a half day off today!

---